Metabolic syndrome comprises a number of components that have been associated with an increased risk of cardiovascular disease. One type of metabolic syndrome is referred to as insulin resistance syndrome or syndrome X, and is a cluster of risk factors that plays a role in cardiovascular disease morbidity among overweight and obese patients and those persons with type 2 diabetes mellitus. (See generally, Deen, American Family Physician, 2004, 69: 2875-2882.) A report from the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III) identified metabolic syndrome as an independent risk factor for cardiovascular disease.
Insulin resistance, abdominal obesity, high blood pressure and lipid disorders (i.e., elevated levels of triglycerides and low levels of high-density lipoprotein (HDL) cholesterol) are all characteristics indicative of metabolic syndrome. According to the NCEP-ATP III, a subject having any three of the above abnormalities is deemed to be afflicted with metabolic syndrome. Table 1 provides a summary of two different definitions for classifying a subject as having metabolic syndrome.
TABLE 1WHO diagnosticATP III diagnosticcriteria (insulincriteriaresistance plus two of(three of theComponentthe following)following)Abdominal/centralWaist to hip ratio: Waist circumference: obesity>0.90 (men), >0.85>102 cm (40 in) in men,(women), or BMI >30>88 cm (35 in) inkg per m2womenHypertriglyceridemia≥150 mg per dL (≥1.7≥150 mg per dLmmol per L)Low HDL<35 mg per dL (<0.9<40 mg per dL cholesterolmmol per L) for men, (<1.036 mmol per L) for<39 mg per dL (<1.0men, <50 mg per dL mmol per L) for women(<1.295 mmol per L) forwomenHigh blood pressure≥140/90 mm Hg or≥130/85 mm Hg ordocumented use ofdocumented use ofantihypertensiveantihypertensivetherapytherapyHigh fasting glucoseImpaired glucose≥110 mg per dL (≥6.1fasting glucose, insulinmmol per L)resistance, or diabetesMicroalbuminuriaUrinary albumin tocreatinine ratio: 30 mgper g, or albuminexcretion rate:20 mcgper minute(Reproduced from Deen, supra)